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Factors associated with high alanine aminotransferase (ALT) and cirrhosis in people living with HIV on combination antiretroviral treatment (cART) in the Asia-Pacific

Rupasinghe D 1 , Choi JY 2 , Yunihastuti E 3 , Kiertiburanakul S 4 , Ross J 5 , Ly PS 6 Show all authors , Chaiwarith R 7 , Do CD 8 , Chan YJ 9 , Kumarasamy N 10 , Avihingsanon A 11 , Kamarulzaman A 12 , Khusuwan S 13 , Zhang F 14 , Lee MP 15 , Van Nguyen K 16 , Merati TP 17 , Sangle S 18 , Oon Tek N 19 , Tanuma J 20 , Ditangco R 21 , Sim BLH 22 , Pujari S 23 , Jiamsakul A 1 , TREAT Asia HIV Observational Database (TAHOD) of IeDEA Asia-Pacific

Affiliations 

  • 1 The Kirby Institute, UNSW Sydney, NSW, Australia
  • 2 Department of Internal Medicine, Division of Infectious Diseases, Yonsei University College of Medicine, Seoul, South Korea
  • 3 Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
  • 4 Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • 5 TREAT Asia, amfAR-The Foundation for AIDS Research, Bangkok, Thailand
  • 6 National Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia
  • 7 Research, Institute for Health Sciences, Chiang Mai, Thailand
  • 8 Bach Mai Hospital, Hanoi, Vietnam
  • 9 Taipei Veterans General Hospital, Taipei, Taiwan
  • 10 CART CRS, Voluntary Health Services, Chennai, India
  • 11 HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand
  • 12 University Malaya Medical Centre, Kuala Lumpur, Malaysia
  • 13 Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
  • 14 Beijing Ditan Hospital, Capital Medical University, Beijing, China
  • 15 Queen Elizabeth Hospital, Kowloon, Hong Kong SAR
  • 16 National Hospital for Tropical Diseases, Hanoi, Vietnam
  • 17 Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia
  • 18 BJ Medical College and Sassoon General Hospitals, Pune, India
  • 19 Tan Tock Seng Hospital, Singapore, Singapore
  • 20 National Center for Global Health and Medicine, Tokyo, Japan
  • 21 Research, Institute for Tropical Medicine, Muntinlupa City, Philippines
  • 22 Hospital Sungai Buloh, Sungai Buloh, Malaysia
  • 23 Institute of Infectious Diseases, Pune, India
J Med Virol, 2022 Nov;94(11):5451-5464.
PMID: 35869413 DOI: 10.1002/jmv.28019

Abstract

Liver disease is a growing burden among people living with HIV (PLHIV) in resource-limited settings. As an indicator of liver disease, risk factors of high alanine aminotransferase (ALT) and cirrhosis were assessed among PLHIV in the TREAT Asia HIV Observational Database (TAHOD). Patients on combination antiretroviral therapy (cART) with a pre-cART ALT measurement and at least one follow-up ALT measurement were included. Factors associated with high ALT (ALT levels > 5 times its upper limit of normal) were analyzed using repeated measure logistic regression over a 10-year follow-up period. Liver cirrhosis was defined as having an AST to Platelet Ratio Index score > 1.5, fibrosis-4 score > 3.25, or a clinical diagnosis of cirrhosis. Cox regression analysis stratified by site was used to analyze factors associated with cirrhosis among those in follow-up after 2015. Of 5182 patients, 101 patients (1.9%) had high ALT levels with hepatitis C virus (HCV) antibody positive (odds ratio [OR]: 4.98, 95% confidence interval [CI]: 2.82-8.77, p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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